Which subtype of acute myelogenous leukemia is associated with disseminated intravascular coagulation (DIC)?

Acute promyelocytic leukemia (APL), classified as M3 in the French-American-British (FAB) classification of acute myeloid leukemia, is notably associated with disseminated intravascular coagulation (DIC). This condition arises due to the release of pro-coagulant factors from promyelocytes, which are typically abundant in APL. APL cells often contain a fusion gene product from the promyelocytic leukemia-retinoic acid receptor alpha (PML-RARA) rearrangement, which disrupts normal myeloid differentiation and function.

DIC is characterized by the systemic activation of the coagulation cascade, leading to the formation of fibrin clots in small blood vessels. In APL, DIC results from the rapid proliferation of promyeloblasts and the associated release of thromboplastic material into the circulation, which overwhelms the body's ability to regulate coagulation. Because of this association, patients with M3 leukemia often present with clinical features of bleeding, thrombocytopenia, and elevated clotting markers, which are key indicators of DIC.

Understanding the linkage between APL and DIC helps to recognize the need for immediate intervention with all-trans retinoic acid (ATRA) and potentially supportive